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Porous tip contact force–sensing catheters for pulmonary vein isolation: performance in a clinical routine setting

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Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

Abstract

Purpose

In catheter ablation of atrial fibrillation (AF), contact force (CF)–sensing catheters with an irrigated tip are used to deliver radiofrequency (RF) energy to the tissue. The ThermoCool® Smarttouch™ Surroundflow catheter (STSF) integrates CF-sensing technology and a new porous tip for advanced external cooling. The aim was to evaluate the performance and safety of STSF in a clinical setting of pulmonary vein isolation (PVI) in comparison with standard contact force–sensing catheter (ST).

Methods

We assigned consecutive patients (n = 80, prospectively, open-label, non-randomized) with symptomatic AF to either PVI with STSF (n = 60) or ST (n = 20).

Results

Total ablation time to achieve PVI was significantly shorter in STSF compared to that in ST (STSF, 1556 ± 435 s vs. ST, 1922 ± 961 s; p = 0.045). Ablation time to achieve loss of pace capture of left pulmonary veins was shorter using STSF (left veins, 155 ± 140 s vs. 291 ± 188 s; p = 0.01; right veins, 208 ± 196 s vs. 369 ± 306 s; p = 0.09). Furthermore, administered irrigation fluid was significantly reduced in STSF (241.4 ± 79.6 ml vs. 540.3 ± 229.5 ml; p < 0.01). CF was lower during ablation of left pulmonary veins. One steam pop occurred in STSF, which did not lead to pericardial effusion (vs. no steam pop in ST). The Kaplan–Meier estimate 12-month AF recurrence was 34.3% and 37.7% (p = 0.8).

Conclusions

Integrating CF technology and the porous tip technology enables effective energy transfer to the tissue resulting in shorter ablation time and less irrigation fluid administration. In our cohort, PVI using the STSF was not associated with an increased complication rate or AF recurrence rate after 12-month follow-up when compared with the ST.

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Authors and Affiliations

  1. Department of Electrophysiology, Heart Center, University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany

    Tobias Plenge, Jan-Hendrik van den Bruck, Jakob Lüker, Arian Sultan & Daniel Steven

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  1. Tobias Plenge
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  2. Jan-Hendrik van den Bruck
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Correspondence to Tobias Plenge.

Ethics declarations

All patients provided written informed consent and local ethics committee approval was obtained.

Conflict of interest

Tobias Plenge: none to declare.

Jan-Hendrik van den Bruck: none to declare.

Jakob Lüker: none to declare.

Arian Sultan: none to declare.

Daniel Steven received lecturer fees during the conduct of this study from Biosense Webster and research grant support from Biosense Webster outside the submitted work.

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Plenge, T., van den Bruck, JH., Lüker, J. et al. Porous tip contact force–sensing catheters for pulmonary vein isolation: performance in a clinical routine setting. J Interv Card Electrophysiol 57, 251–259 (2020). https://doi.org/10.1007/s10840-019-00591-2

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  • DOI: https://doi.org/10.1007/s10840-019-00591-2

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